IATROGENIC VENTRICULAR SEPTAL DEFECT DURING RIGHT VENTRICULAR ASSIST DEVICE INSERTION IN CONGENITALLY CORRECTED TRANSPOSITION OF THE GREAT ARTERIES
Short Title: Iatrogenic VSD during RVAD implantation
Mimi Xiaoming Deng MD1, 2, Aamir Jeewa MB BCh3, Osami Honjo MD, PhD1,2
1 Division of Cardiovascular Surgery, Labatt Family Heart Centre, The Hospital for Sick Children, Toronto, Canada
2 Department of Surgery, University of Toronto, Toronto, Canada
3 Division of Pediatric Cardiology, The Hospital for Sick Children, Toronto, Canada
IRB approval and clinical trial registration are not applicable. No external sources of funding. Case was displayed as a poster presentation for the International Society for Heart and Lung Transplant Annual Meeting 2021, virtual, April 24-28, 2021.
Total word count: 1390/1500
Corresponding Author:  Osami Honjo, MD, PhD
Division of Cardiovascular Surgery, Labatt Family Heart Center,
The Hospital for Sick Children 555 University Avenue Toronto, ON, Canada, M5G1X8
Email: osami.honjo@sickkids.ca
Phone: +1 416-813-6420 Fax: +1 416-813-7984
Key words: Congenital; Pediatric; Surgery; Transplant
Abstract (97/150 words)
This case report describes the management of a large iatrogenic ventricular septal defect (VSD) created by the coring device during systemic ventricular assist device (RVAD) insertion in a 16 year-old patient with congenitally corrected transposition of the great arteries. The VSD was closed by bovine pericardial patch and the ventriculotomy was extended laterally to relocate the VAD sewing ring. After RVAD implantation, patient initially remained cyanotic, potentially due to a tiny VSD patch leak with right to left shunting. Hypoxia was successfully corrected by rescue nitric oxide infusion and patient was bridged to transplant after 91 days.